Help me understand these blood test results, PLEASE!

[MrsJewelsRae]

I am so confused right now.  The ped just called me with my ds` results, on behalf of the allergist.  He has reacted to eggs, soy, milk and peanuts - orally.  Eggs- lightly cooked= severe vomiting and diarrhea, freakishly pale, touched raw egg=hives, no reaction to eggs in baking such as cookies, pancakes, etc.  Drinking cow`s milk or ice cream= severe vomiting, very pale.  No reaction ever to yogurt or cheese, which he has eaten frequently.  Drank soy milk= moderate vomiting (but only tried once).  Peanuts- first exposure at 22 months= hives, rash, intense eye and ear itching, swelling eyes, slight tongue swelling and/or throat tingling, very pale- symptoms subsided with Benadryl. 

Ok, so 2 weeks ago he did the skin test.  Doc says severe reaction to peanuts- very large "wheal", severe to eggs, very mild to dairy and soy.  Suggested the milk could be a lactose issue. 

Last week he had some cow`s milk accidentally in a few sips of my protein shake and had his worst gut reaction yet.  He turned very pale and had what I`ve read about as that awful look of extreme sadness or doom, he vomited severely for about 20-30 minutes and was just horribly ill looking, also had sneezing and runny nose. 

Anyhow, they did a blood test- but I do not know which one it was- RAST or IgG/IgE??  The ped said his numbers indicated a very severe milk allergy.  He wants me to cut out all milk products immediately.  Meet with a dietician.  Look into putting him on Alimentum to meet his nutritional needs.  Suggested goat`s milk could be tried.  Set up a follow up appointment with the allergist.

How can my ds eat yogurt and cheese with no reaction but be "severely allergic" to cow`s milk protein?   How do I interpret his numbers, on what scale are they based?  And what about soy?  I don`t give him soy milk but I don`t rule out foods w/ soy in them and he`s never had a problem with them.  But I don`t want to be sensitizing him and building his allergy to the soy or especially the milk, kwim?  Here are the numbers:

Milk- 23

Peanuts- 16

Soya- 8

Egg white- 2

Please help, I am so lost right now.

[scsigrl]

Numbers mean very little.  There are people with high numbers and little reaction and the other way as well.  A reaction to a food trumps a test result in any case.  Tests are about 50% on accuracy (though higher 90%is for a negative result).  

So you know he reacts to peanut, egg and dairy.  I would take all dairy out for a few weeks and if you say he doesn't have issues with cheese and yogurt try those one at a time a few days apart and make sure there isn't.  You say he doesn't react to soy, so I would leave it.  Foods change when cooked so it is totally possible to be fine with baked in egg but not lightly cooked os that's not unusual esp. as a kid is outgrowing things.

Dinner time.  Hope that answers a few of your questions. 

Also, did you get a script for an epi pen?  I would ask for one.

[MrsJewelsRae]

Thanks.  I`ve had an epi pen since his first peanut reaction, we now carry 2 wherever he goes.  I know that baking will usually denature the protein of egg and milk, but I don`t know what temp and how long things aught to cook in order to do this so that they are not sensitizing him... like pancakes are cooked through, but they`re only on a heat source for a couple minutes...hrmmm...

[scsigrl]

When they say baked, they usually mean baked in the oven at 350 and all that.  I would not do pancakes with eggs but again, that is MY comfort level ;)

[MrsJewelsRae]

Also, is it foolish of me to not worry as much about the milk allergy as the peanuts?  I just can`t believe he is supposedly so allergic to milk when he has never reacted to yogurt and cheese.  What I mean is- our house is PEANUT FREE, and we have had our church go the same way with foods served on the premises.  But, at this point I really don`t see us getting rid of all traces of milk in our house- though I will from his diet, I`m far more afraid of the peanuts- though logically I know this can`t make much sense because I know that lots of people die from milk exposure.... I`m afraid I`m not making much sense... Basically, I tend to think that accidental peanut exposure via skin to skin is more dangerous than milk, for my ds anyways.

Oh, and is it wise to just start adding in goat`s milk w/o first testing to see if he is allergic?  Plus they didn`t test him for other nuts, though we avoid them anyhow.

[scsigrl]

We do have milk in the house as well and are peanut free.  I get it.  Again, for me it's within my comfort level.  We are careful about it but we do have it in the house.  I don't know the statistics but I would think if there is a tolerance to cheese then the chance of an ana reaction to milk is pretty low.  
 

As for goat milk, "they" say that the proteins in cow and goat are pretty similar and they usually people who are allergic to one are to the other as well.  If your Dr. said okay to try it and you want to, there you go.  I wouldn't because of all I have heard but again, that's me ;)

[kjbrown92]

I'm confused. You say that he only tried soy once and vomited, but you're thinking of putting him on it?

The skin test showed mild for milk, but a blood test showed highly allergic? Usually the skin test trumps the blood test, because it's more accurate. There are many more false positives/negatives with the blood test. Did they do a test on egg yolk? Or only on the white?

For vomiting, it could be an allergy or an intolerance so if you see a reaction like something, to egg, but it doesn't react on a skin/blood test, it's possible that it's an intolerance. Though with a hives skin reaction, I'd be hesitant.

[MrsJewelsRae]

He only had soy milk once and he threw up a few times so we've avoided it since- BUT he's had foods that have had some soy ingredients, because I figured it was just an intolerance that he'd likely outgrow.  His skin test was very mild, and his # was 8.  I'm NOT going to re-introduce it, but I'm also not sure if I should any of this indicates considering cutting out ALL traces of soy.

The ped seemed concerned that any exposure to milk could be sensitizing him, slowly building his allergy.  I hate to make him give up yogurt and I shudder at the thought of no cheese, but I also don't want to risk a lifelong severe dairy protein allergy due him being sensitized ...

The ped suggested Alimentum or even goat's milk.  I don't know if the goat's milk is a good idea, considering the "severe" cow's milk allergy.  Can't wait for my follow up appointment with the Allergist!